total daily calories, although sugar in most forms, including many fruits, was still forbidden.
Over the next 50 years, as the carbohydrate increased, the percentage of calories from fat gradually decreased because of its known relationship to heart disease. It is important to note that currently, the percentage of carbohydrate is individually based on the dietitian’s nutrition assessment and each individual’s treatment goals.
Home blood glucose monitoring in the 1980s helped reveal how people with diabetes can eat a realistic amount of carbohydrate, based on factors such as blood glucose control, weight, and blood fat levels.
WHAT ARE STARCH AND FIBER?
As we learned in Chapter 2, starch and fiber are commonly known as complex carbohydrates. Starch and fiber are only found in plants, and their structure is composed of 10 or more straight or branched chains of sugar blocks called polysaccharides. Plants store their fuel as starch, so when we eat foods that come from plants, it is converted into glucose for fuel. Because starch is made up of many sugar blocks bonded together, these sugar blocks have to be broken down into their components before they can be used for fuel. The cooking, chewing, and digestive process breaks the bonds holding the sugar blocks together. A couple of hours after eating, all the starch is usually digested and is being used as fuel by the cells of the body.
The best sources of starch are grains, such as rice, wheat, corn, millet, rye, barley, and oats. Legumes (plants from the bean and pea family) and tubers such as potatoes and yams also provide starch.
WHAT IS FIBER?
Fiber is the “roughage” that comes from plant foods that cannot be digested by the human digestive system. It is considered the non-starch polysaccharide and is made up of cellulose, hemicellulose, pectins, gums, mucilages, and lignins. Fiber is what gives plants their structure and is found in all plant foods. Fiber is also the carbohydrate that gives bulk to the digestive tract. Unlike sugar and starch, fiber cannot give us fuel for energy because we cannot break the bonds that hold its sugar blocks together. Therefore, fiber only gives us very limited amounts of fuel and calories.
WHERE ARE STARCH AND FIBER FOUND?
Starch
A strong, healthful meal plan should feature foods rich in starch and fiber, such as breads, cereals, rice, pasta, dry beans, and starchy vegetables. The healthiest choices of breads and cereals are those made from whole grains, in which the whole kernel of grain is left in the flour used to make them. White flour has the bran (coarse outer layer) removed from the kernel of grain for a lighter texture.
Some specific foods in this category, commonly known as the Bread/Starch List, are listed below to give you an idea of how much one serving, or 15 grams of carbohydrate, would be:
Carbohydrate Foods: Breads, Cereals, Rice, Pasta, and Starchy Vegetables
Each of these items contains 15 grams of carbohydrate.
• 1 slice of whole-grain bread
• 1/2 English muffin or small bagel
• 3/4 cup dry cereal or 1/2 cup hot cereal
• 1/3 cup rice, beans, lentils
• 1/2 cup pasta, potato, corn, green peas
• 3 Tbsp flour
• 4–6 crackers
• 3 cups popcorn
Fiber
Fiber is categorized as either soluble or insoluble on the basis of its ability or inability to dissolve in water, respectively. Both soluble and insoluble fibers are called dietary fiber. This term is simply a measure of how much fiber is in a food.
Fiber that dissolves in water is called soluble fiber and includes such foods as citrus fruits, apples, strawberries, oat, wheat, rice bran, barley, leafy vegetables, and dried peas and beans. Soluble fiber cannot retain its structure in the digestion process and forms a gel that binds cholesterol and fats and helps to eliminate them from the body. Soluble fiber also slows the process of food emptying from the stomach. This can mean a slower rise in blood glucose levels after a meal containing adequate fiber.
Fiber that does not dissolve in water is called insoluble fiber and includes such foods as whole-grain cereals, wheat and corn bran, and mature fruits and vegetables, particularly root vegetables. Insoluble fiber works in the colon and has a sponge-like effect that helps push the food through the digestive tract.
WHY DO WE NEED STARCH AND FIBER?
All complex carbohydrates such as grains, breads, cereal, rice, pasta, fruits, vegetables, and legumes are healthy sources of fuel when eaten in moderation. Dessert-type foods that are high in sugar usually do not provide significant fiber, may contain a lot of fat, and are often limited in nutrition. Although sugar (a simple carbohydrate) is also a source of fuel, it should also be eaten in moderation. However, foods like fruits, vegetables, and milk contain forms of sugar as well as many other nutrients and are healthy sources of fuel. Some foods may contain both simple and complex carbohydrate. For example, fruits and vegetables contain both sugar and fiber. Most starches, as well as fruits, vegetables, and legumes, are low in fat and contain many nutrients, including fiber, vitamins, beta carotene, folic acid, zinc, iron, calcium, and selenium. The bulk of our diet, whether we have diabetes or not, should come from complex carbohydrates. They will keep us healthy!
Starch Is Used as a Fat Replacer
When fats are taken out of foods, the most common ingredient used to substitute the fat is a carbohydrate-based replacer in the form of a modified food starch. These food starches provide thickening and gelling abilities. They also stabilize, add texture, and provide structure to an otherwise unstable product. Common foods that may contain fat replacers are frozen desserts, baked goods, sauces, salad dressings, cheese, and gelatin. Often there is more than one fat replacer in the same food. You may recognize some of these carbohydrate-based fat replacers that come from corn, potato, rice, and tapioca, as well as ingredients such as polydextrose and maltodextrin. These fat replacers may cut down the amount of fat in a product but will raise the total carbohydrate content of these foods. It is very important to look at the grams of total carbohydrate on a food label when purchasing any low-fat or fat-free product because these products commonly contain more carbohydrate than expected. Remember that carbohydrate has the biggest impact on blood glucose.
Here’s an example. Let’s say you’re looking at two bottles of blue cheese salad dressing—one is a light dressing and the other is a fat-free dressing.
As you can see above, there’s quite a bit of difference between the two dressings. This demonstrates the need to read food labels and monitor blood glucose after eating these foods to better understand how they will affect you.
THE UPSIDE AND THE DOWNSIDE OF STARCH AND FIBER
The good news for people with diabetes is that all carbohydrate foods can fit into a healthy diet, including starch or fiber. The body breaks down all carbohydrate, except fiber, into glucose (blood sugar) at the same rate, although this may be influenced by factors such as the presence of fat and protein in the same meal. Therefore, first and foremost, it is important to control the total amount of carbohydrate you eat.
The Downside
1. Eating a lot of carbohydrate from starch can lead to weight gain, even with the added benefits of vitamins, minerals, and fiber. Excess calories from any food will be stored as body fat.
2. Starchy foods, such as cake, cookies, muffins, sweet breads, and cereals, have higher amounts of total carbohydrate because of the starch plus the added sugar. Even though these foods may be part of a healthy diet, they may lead to higher blood glucose levels and weight gain. Therefore, the portion sizes should be carefully monitored.
3. If taken in excessive amounts, even fiber may be harmful. If a lot of fiber is consumed in a short period of time, it can cause intestinal gas, bloating, cramps, and